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NPI Code Detail

MEDICARE: DR. FADI M AQEL DDS

MEDICARE:  DR. FADI M AQEL  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist019026128IL

General Provider Information

NPI Number : 1538214101
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FADI M AQEL DDS
Provider Business Mailing Address
First Line : 5917 S PULASKI RD
Second Line :
City : CHICAGO
State : IL
Zip : 60629
Country : US
Telephone Number : 773-735-8353
Fax Number : 773-735-8453
Provider Business Practice Location Address
First Line : 5917 S PULASKI RD
Second Line :
City : CHICAGO
State : IL
Zip : 60629
Country : US
Telephone Number : 773-735-8353
Fax Number : 773-735-8453
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2007
Last Update Date : 02/07/2021

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Directions to “ DR. FADI M AQEL DDS” Practice Location

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